| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RUTH3 | 7276 SNOW APPLE DR. CLARKSTON, MI 483461648 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $43K | $3K | $46K | 1.12% |
| ROBERT G. RUTH3 Filed as: ROBERT RUTH | 7276 SNOW APPLE CLARKSTON, MI 48346 | DELTA DENTAL OF MICHIGAN | $5K | — | $5K | 3.01% |
| JANELLE M. RUTH3 | 4910 IROQUOIS BLVD. CLARKSTON, MI 48348 | NATIONAL VISION ADMINISTRATORS, LLC | $2K | — | $2K | 5.00% |
| MACQUEEN & ASSOCIATES LLC3 | 2191 12 MILE ROAD BERKLEY, MI 480721825 | AETNA LIFE INSURANCE CARRIER | $3K | — | $3K | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 NONE | Direct payment from the plan; Claims processing; Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Consulting (general) Service code 12 | — | $4.1M |
| DELTA DENTAL OF MICHIGAN EIN 38-1791480 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services; Claims processing; Other fees Service code 12 | — | $168K |
| BLUE CARE NETWORK OF MICHIGAN EIN 38-2359234 NONE | Direct payment from the plan; Other fees; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance services; Claims processing Service code 12 | — | $106K |
| BENESYS, INC. EIN 38-2383171 NONE | Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 700 TOWER DRIVE TROY, MI 48089 | $103K |
| ROOFERS UNION LO. 70 BENEFIT FUNDS CONTRIBUTING EMPLOYER | Other services; Direct payment from the plan Service code 49 | P.O. BOX 766 HOWELL, MI 488440766 | $64K |
| NATIONAL VISION ADMINISTRATORS, LLC EIN 43-0949844 NONE | Claims processing; Other fees; Direct payment from the plan; Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 12 | — | $42K |
| DEBRA SACK EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 253 DARTMOOR WHITMORE LAKE, MI 48189 | $30K |
| LAURA LONDON EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 210 S. NATIONAL HOWELL, MI 48843 | $29K |
| AETNA INC. NONE | Claims processing; Direct payment from the plan; Consulting (general); Insurance services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 12 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $29K |
| BULTYNCK & CO., P.L.L.C. EIN 20-3920878 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 15985 CANAL ROAD CLINTON TOWNSHIP, MI 48038 | $13K |
| ROOFERS JOINT EDUCATION TRUST FUND NONE | Other services; Direct payment from the plan Service code 49 | 1660 L STREET N.W. WASHINGTON, DC 20036 | $13K |
| MONROE & ASSOCIATES, INC. NONE | Direct payment from the plan; Actuarial Service code 11 | 25901 W. 10 MILE, STE 200 SOUTHFIELD, MI 48033 | $9K |
| UNION SERVICES AGENCY NONE | Direct payment from the plan; Insurance services Service code 23 | 119 PERE MARQUETTE LANSING, MI 48912 | $8K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 756 | $4.2M |
| Dental | DELTA DENTAL OF MICHIGAN | 768 | $168K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 767 | $42K |
| Life insurance | AETNA LIFE INSURANCE CARRIER | 437 | $29K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 756 | $4.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 768 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.